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蝎子蜇伤:最新情况

Scorpion sting: update.

作者信息

Bawaskar Himmatrao Saluba, Bawaskar Pramodini Himmatrao

机构信息

Bawaskar Hospital and Research Centre, Mahad, Raigad, Maharashtra, India.

出版信息

J Assoc Physicians India. 2012 Jan;60:46-55.

Abstract

Scorpion envenomation is an important public health hazard in tropical and sub-tropical regions. Envenomation by scorpions can result in a wide range of clinical effects, including, cardiotoxicity, neurotoxicity and respiratory dysfunction. Out of 1500 scorpion species known to exist, about 30 are of medical importance. Although a variety of different scorpion species exist, majority of them produce similar cardiovascular effects. Scientists and clinicians have studied patho-physiology of scorpion envenomation by critical observations of clinical, neurotransmitters studies, radioisotope studies, echocardiography and haemodynamic patterns. Regimen including scorpion antivenom, vasodilators, intensive care management have been tried to alleviate the systemic effects of envenoming. In spite of advances in patho-physiology and therapy the mortality remains high in rural areas due to lack of access to medical facilities, moreover the medical attendee from developing tropical countries may not be aware of the advances in the treatment of scorpion sting. Since the advent of scorpion Antivenom, vasodilators, dobutamine and intensive care facilities, the fatality due to severe scorpion sting has been significantly reduced in areas where these treatment modalities are used.

摘要

蝎子蜇伤是热带和亚热带地区一项重要的公共卫生危害。蝎子蜇伤可导致广泛的临床症状,包括心脏毒性、神经毒性和呼吸功能障碍。在已知存在的1500种蝎子物种中,约30种具有医学重要性。虽然存在多种不同的蝎子物种,但它们中的大多数会产生相似的心血管效应。科学家和临床医生通过对临床症状的密切观察、神经递质研究、放射性同位素研究、超声心动图和血流动力学模式,对蝎子蜇伤的病理生理学进行了研究。包括蝎子抗毒血清、血管扩张剂、重症监护管理在内的治疗方案已被尝试用于减轻蜇伤的全身影响。尽管在病理生理学和治疗方面取得了进展,但由于农村地区缺乏医疗设施,死亡率仍然很高,此外,来自热带发展中国家的医护人员可能并不了解蝎子蜇伤治疗方面的进展。自从有了蝎子抗毒血清、血管扩张剂、多巴酚丁胺和重症监护设施后,在使用这些治疗方式的地区,严重蝎子蜇伤导致的死亡率已显著降低。

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